1
|
Horak P, Heining C, Kreutzfeldt S, Hutter B, Mock A, Hullein J, Frohlich M, Uhrig S, Jahn A, Rump A, Gieldon L, Mohrmann L, Hanf D, Teleanu V, Heilig CE, Lipka DB, Allgauer M, Ruhnke L, Lassmann A, Endris V, Neumann O, Penzel R, Beck K, Richter D, Winter U, Wolf S, Pfutze K, Georg C, Meissburger B, Buchhalter I, Augustin M, Aulitzky WE, Hohenberger P, Kroiss M, Schirmacher P, Schlenk RF, Keilholz U, Klauschen F, Folprecht G, Bauer S, Siveke JT, Brandts CH, Kindler T, Boerries M, Illert AL, von Bubnoff N, Jost PJ, Spiekermann K, Bitzer M, Schulze-Osthoff K, von Kalle C, Klink B, Brors B, Stenzinger A, Schrock E, Hubschmann D, Weichert W, Glimm H, Frohling S. Comprehensive Genomic and Transcriptomic Analysis for Guiding Therapeutic Decisions in Patients with Rare Cancers. Cancer Discov 2021; 11:2780-2795. [PMID: 34112699 DOI: 10.1158/2159-8290.cd-21-0126] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/03/2021] [Accepted: 05/25/2021] [Indexed: 11/16/2022]
Abstract
The clinical relevance of comprehensive molecular analysis in rare cancers is not established. We analyzed the molecular profiles and clinical outcomes of 1,310 patients (rare cancers, 75.5%) enrolled in a prospective observational study by the German Cancer Consortium that applies whole-genome/exome and RNA sequencing to inform the care of adults with incurable cancers. Based on 472 single and six composite biomarkers, a cross-institutional molecular tumor board provided evidence-based management recommendations, including diagnostic reevaluation, genetic counseling, and experimental treatment, in 88% of cases. Recommended therapies were administered in 362 of 1,138 patients (31.8%) and resulted in significantly improved overall response and disease control rates (23.9% and 55.3%) compared to previous therapies, translating into a progression-free survival ratio >1.3 in 35.7% of patients. These data demonstrate the benefit of molecular stratification in rare cancers and represent a resource that may promote clinical trial access and drug approvals in this underserved patient population.
Collapse
Affiliation(s)
- Peter Horak
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg
| | - Christoph Heining
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Dresden
| | | | - Barbara Hutter
- Division of Applied Bioinformatics, German Cancer Research Center
| | | | | | - Martina Frohlich
- Computational Oncology, Molecular Diagnostics Program, German Cancer Research Center
| | - Sebastian Uhrig
- Division of Applied Bioinformatics, German Cancer Research Center
| | - Arne Jahn
- Institute for Clinical Genetics, Faculty of Medicine Carl Gustav Carus, Technical University Dresden
| | - Andreas Rump
- Institute for Clinical Genetics, Faculty of Medicine Carl Gustav Carus
| | - Laura Gieldon
- Heidelberg University Hospital, Institute of Human Genetics
| | - Lino Mohrmann
- Translational Medical Oncology, National Center for Tumor Diseases Dresden
| | - Dorothea Hanf
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Dresden
| | - Veronica Teleanu
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg
| | - Christoph E Heilig
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg
| | - Daniel B Lipka
- Section Translational Cancer Epigenomics; Division Translational Medical Oncology, German Cancer Research Center
| | | | - Leo Ruhnke
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Dresden
| | - Andreas Lassmann
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg
| | | | - Olaf Neumann
- Department of General Pathology, University Hospital Heidelberg
| | | | - Katja Beck
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg
| | | | - Ulrike Winter
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg
| | - Stephan Wolf
- Genomics and Proteomics Core Facility, German Cancer Research Center
| | - Katrin Pfutze
- Center for Personalized Medicine, National Center for Tumor Diseases
| | - Christina Georg
- Department of Translational Oncology, National Center for Tumor Diseases
| | - Bettina Meissburger
- Sample Processing Laboratory, Molecular Diagnostics Program, German Cancer Research Center
| | - Ivo Buchhalter
- Omics IT and Data Management Core Facility, German Cancer Research Center
| | - Marinela Augustin
- Department of Hematology and Oncology, Paracelsus Medical University, Nuremberg
| | | | | | - Matthias Kroiss
- Comprehensive Cancer Center Mainfranken, University of Würzburg
| | | | - Richard F Schlenk
- NCT Clinical Trials Center, Heidelberg University Hospital and German Cancer Research Center
| | | | | | - Gunnar Folprecht
- University Cancer Center / Medical Department I, University Hospital Carl Gustav Carus
| | - Sebastian Bauer
- Department of Medical Oncology, Sarcoma Center, West German Cancer Center, University Duisburg-Essen, Medical School, Essen, Germany; DKTK partner site Essen and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Jens Thomas Siveke
- West German Cancer Center, University Hospital Essen, Bridge Institute of Experimental Tumor Therapy
| | - Christian H Brandts
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University
| | - Thomas Kindler
- Third Department of Medicine, University Medical Center of the Johannes Gutenberg University
| | - Melanie Boerries
- Medical Center - University Freiburg, Institute of Medical Bioinformatics and Systems Medicine
| | - Anna L Illert
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg
| | - Nikolas von Bubnoff
- Department of Hematology and Oncology, Medical Center, University of Schleswig-Holstein, Campus Lübeck
| | | | | | | | | | | | - Barbara Klink
- Institute for Clinical Genetics, Faculty of Medicine Carl Gustav Carus, TU Dresden
| | - Benedikt Brors
- Department of Applied Bioinformatics, German Cancer Research Center
| | | | - Evelin Schrock
- Institute for Clinical Genetics, Faculty of Medicine Carl Gustav Carus, Technical University Dresden
| | | | - Wilko Weichert
- Institute of General Pathology and Pathological Anatomy, Technical University of Munich
| | - Hanno Glimm
- Department of Translational Oncology, NCT National Center for Tumor Diseases
| | - Stefan Frohling
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg
| |
Collapse
|